The Modification of Diet in Renal Disease 4-calculated glomerular filtration rate is a better prognostic factor of cardiovascular events than classical cardiovascular risk factors in patients with peripheral arterial disease

Bover, Jordi; Fité, Joan; Bellmunt, Sergi; Dilmé, Jaime-Félix; Camacho, Mercedes; Vilá, Luis M.; Escudero, José Román

doi:10.1016/j.jvs.2012.04.049

Cited by 17 publications

(15 citation statements)

References 36 publications

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“…11 Kidney function has increasingly displayed greater predictive value of CV events in patients with atherosclerosis than traditional risk factors. 9,10 Kidney failure patients have extremely low FMD, even more so than those of PAD patients. 29 Once advanced kidney disease is present, it may contribute to the progression of systemic endothelial dysfunction more than traditional cardiovascular risk factors do.…”

Section: Discussionmentioning

confidence: 99%

“…7 Current evidence suggests that decreased kidney function is not only an independent predictor of CV events, it may also be a stronger predictor than traditional risk factors. 9,10 In the setting of PAD, the presence of kidney disease predicts worse outcomes after peripheral revascularization. 11 Kidney disease is known to produce a state of oxidative stress and inflammation, 12 both of which are strong depressors of endothelial function.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between kidney disease and endothelial function in peripheral artery disease

Chong

Owens

Park

et al. 2014

Journal of Vascular Surgery

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Objective We have previously shown that peripheral artery disease (PAD) is associated with marked impairment of endothelial function (EF). Given that poor EF is associated with functional status of PAD patients as well as increased morbidity and mortality in patients undergoing vascular procedures, determining factors associated with poor EF in a PAD cohort is important. We hypothesized that decreased kidney function is associated with impaired endothelial function (EF) in patients with PAD. Methods This was a cross-sectional study of PAD patients presenting to a vascular surgery outpatient clinic at the San Francisco Veterans Affairs Medical Center including patients enrolled into the OMEGA-PAD I trial (NCT01310270) and the OMEGA-PAD Cohort. Brachial artery flow-mediated vasodilation (FMD) was performed to assess EF. Kidney function was characterized by eGFR using the abbreviated Modification of Diet in Renal Disease formula. Linear regression was performed to assess the relationship between EF and kidney function in claudicants. Results 97 patients with intermittent claudication participated in this study. Mean age was 69 ± 8 years, 97% were male, and 77% were Caucasian. Comorbidities included hypertension (91%), dyslipidemia (87%), coronary artery disease (42%) and diabetes mellitus (38%). Mean ABI was 0.73 ± 0.14 and mean FMD was 7.0% ± 3.8, indicating impaired EF. Linear regression showed an association between kidney function and EF (by 10 ml/min/1.73m2, β: 0.12; CI: 0.05, 0.20; P = .001). After multivariable regression adjusting for age, race, log TNF-α, hypertension, dyslipidemia, and diabetes, eGFR remained significantly associated with EF (P = .033). Conclusions In patients with PAD, decreased kidney function is associated with endothelial dysfunction. Further longitudinal studies are needed to better understand the impact of kidney function on PAD progression and the role of endothelial dysfunction in this process.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Relationship between kidney disease and endothelial function in peripheral artery disease

Chong

Owens

Park

et al. 2014

Journal of Vascular Surgery

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“…Many reports provide evidence supporting the association between renal function and atherosclerosis, and eGFR is an independent prognostic factor for cardiovascular disease [32]. We recently reported that eGFR is an excellent predictor of vascular events in patients with peripheral arterial disease [33]. Since RI could indicate the atherosclerosis level of patients, our results suggest that the effect of smoking on local levels of mPGES-1/EP-4 is independent of the atherosclerosis and COPD states of patients with AAA.…”

Section: Discussionmentioning

confidence: 99%

Active Smoking Increases Microsomal PGE₂-Synthase-1/PGE-Receptor-4 Axis in Human Abdominal Aortic Aneurysms

Dilmé¹,

Solà-Villà

Bellmunt³

et al. 2014

Mediators of Inflammation

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Background. The cyclooxygenase- (COX-) 2/microsomal PGE-synthase- (mPGES-) 1/PGE-receptor- (EP-) 4 axis could play a key role in the physiopathology of abdominal aortic aneurysm (AAA) in humans. In this study, we investigated the influence of cardiovascular risk factors on the expression of the PGE2 pathway in human AAA. Methods. Aortic (n = 89) and plasma (n = 79) samples from patients who underwent AAA repair were collected. Patients were grouped according to risk factors. COX-isoenzymes, mPGES-1, EPs, α-actin, and CD45 and CD68 transcripts levels were quantified by QRT-PCR and plasma PGE2 metabolites by EIA. Results. Current smoking (CS) patients compared to no-CS had significantly higher local levels of mPGES-1 (P = 0.009), EP-4 (P = 0.007), and PGE2 metabolites plasma levels (P = 0.008). In the multiple linear regression analysis, these parameters remained significantly enhanced in CS after adding confounding factors. Results from association studies with cell type markers suggested that the increased mPGES-1/EP-4 levels were mainly associated with microvascular endothelial cells. Conclusions. This study shows that elements of the PGE2 pathway, which play an important role in AAA development, are increased in CS. These results provide insight into the relevance of tobacco smoking in AAA development and reinforce the potential of mPGES-1 and EP-4 as targets for therapy in AAA patients.

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“…GFR was estimated from standardized serum creatinine using the 4-variable Modification of Diet in Renal Disease (MDRD) equation. Serum creatinine was measured using the Jaffe alkaline picrate method (Hoffmann-La Roche, USA) traceable to isotope dilution mass spectrometry values [15].…”

Section: Methodsmentioning

confidence: 99%

Renal dysfunction and 30-day mortality risk in patients with acute stroke

Busari

Amira²,

Bello³

et al. 2019

AJN

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interest in reduced glomerular filtration rate (GFR) as an independent non-traditional risk factor for CVD and CVD mortality has come to the fore [4,5]. Studies suggest that reduced GFR may be an independent risk factor for poor outcomes in patients with myocardial infarction and stroke [6-8]. Yohalom et al. [8], in a prospective study involving 821 Israeli adults with acute stroke, found that reduced GFR was a strong independent predictor of mortality and poor outcomes. Mortality was associated

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The Modification of Diet in Renal Disease 4-calculated glomerular filtration rate is a better prognostic factor of cardiovascular events than classical cardiovascular risk factors in patients with peripheral arterial disease

Abstract: The MDRD-4 GFR was a better predictor of risk of death or infarction than classical cardiovascular risk factors in patients with PAD. This suggests that its routine use in the initial evaluation in patients with PAD is beneficial.

Cited by 17 publications

References 36 publications

Relationship between kidney disease and endothelial function in peripheral artery disease

Relationship between kidney disease and endothelial function in peripheral artery disease

Active Smoking Increases Microsomal PGE₂-Synthase-1/PGE-Receptor-4 Axis in Human Abdominal Aortic Aneurysms

Renal dysfunction and 30-day mortality risk in patients with acute stroke

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The Modification of Diet in Renal Disease 4-calculated glomerular filtration rate is a better prognostic factor of cardiovascular events than classical cardiovascular risk factors in patients with peripheral arterial disease

Abstract: The MDRD-4 GFR was a better predictor of risk of death or infarction than classical cardiovascular risk factors in patients with PAD. This suggests that its routine use in the initial evaluation in patients with PAD is beneficial.

Cited by 17 publications

References 36 publications

Relationship between kidney disease and endothelial function in peripheral artery disease

Relationship between kidney disease and endothelial function in peripheral artery disease

Active Smoking Increases Microsomal PGE2-Synthase-1/PGE-Receptor-4 Axis in Human Abdominal Aortic Aneurysms

Renal dysfunction and 30-day mortality risk in patients with acute stroke

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Product

Resources

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Active Smoking Increases Microsomal PGE₂-Synthase-1/PGE-Receptor-4 Axis in Human Abdominal Aortic Aneurysms